Director, Government Operations

Organizational Overview

DST Health Solutions, LLC, delivers contemporary healthcare technology and service solutions that enable clients to thrive in a complex, rapidly evolving market. Providing business solutions developed from a unique blend of industry experience, technological expertise, and service excellence, we assist our clients in improving efficiencies while also effectively managing the processes, information, and products that directly impact quality outcomes.

Role Overview

Reporting to the Chief Operating Officer, the Director of Government Health Plan Operations will accountable for Medicare Advantage, Medicaid, and Exchange Billing, Enrollment, Reconciliation and EDI for BPO clients. This individual will interface directly with all departments at multiple levels within Delivery and directly with our clients.

Responsibilities

• Lead operational efforts between Shared Services, Call Center, Command Center, IT Implementation and the client
• Ensure all policies, procedures and workflow are documented by government line of business and client
• Manage inventories by line of business and client and ensure timeliness metrics are met
• Implement and adhere to all applicable rules, regulations and reporting requirements
• Work closely with the Product Development organization to CTO ensure all necessary client data is properly managed through the EDI process
• Work closely with the Finance department to ensure an accurate budget and forecast
• Lead government billing operations
• Must work cross functionally with compliance and legal
• Must be able to develop comprehensive CAPs/RCAs

Qualifications

• Bachelor’s degree or 7 to 10 years of experience in running operations

5+ years of administrative/management experience in health plan operations, Medicare Advantage and Medicaid health plan experience is a plus
Experienced in enrollment, eligibility and reconciliation processes and electronic data interchange (EDI) requirements, and reporting
Self-starter, proactive, who works quickly and accurately and will prioritize and meet deadlines effectively
Strong interpersonal, decision-making, financial and technical skills; must be able to introduce new ideas, processes, and tools to improve company performance
Strong leadership, analytical, project planning and coordination skills
High energy; demonstrates an ability to function in a creative, entrepreneurial environment and think outside the box
Superior verbal, written and telephone communication skills
Superior organization and multi-tasking skills; detail-oriented
Location: Birmingham Alabama
DST is an equal opportunity employer and values a diverse and inclusive workplace. All qualified candidates will receive consideration for employment without regard to age, race, color, religion, genetic information, sex, sexual orientation, gender identity, national origin, disability status, protected veteran status, or any other characteristic protected by law. For more information about Equal Opportunity in the Workplace please click here and here . DST is committed to working with and providing reasonable accommodation to job applicants with disabilities. If you are a qualified individual with a disability and need an accommodation or accessibility assistance to complete the online application, please contact us at PeopleCenter@dstsystems.com for assistance.